Background: Central to the utility of health education in the control of schistosomiasis is an understanding of the way a community perceives, understands, and can explain how schistosomiasis occurs among them. Methods: In order to study the environmental, social, and cultural determinants of continued schistosomiasis prevalence in Eggua, we administered semi-structured questionnaires to 372 adults between November 2012 and December 2015 which asked about the perceptions, understanding of the community and the patterns of schistosomiasis. Results: The respondents’ ages ranged from 35 to above 60 years. 44.7% had no schooling and 39.6% had at least primary education. 48.4% were farmers, 29.8% traders, and 1.6% fisher-folk. Majority (79%, 95% CI 76.5–83.0) were of a Christian denomination where members spend long periods in the river praying. Water contact was frequent with 89.5% visiting the rivers daily. Despite the research surveys taking place in Yewa since 2009, 81.5% of respondents did not know the cause of blood in urine, and self-reported hematuria was low, 4.6%. Latrine use was negligible, up to 95% of respondents did not have a latrine. Those who had heard about schistosomiasis were not well educated on prevention methods; 89.5% did not know they could be re-infected after the treatment. Conclusion: Formal Health Education initiatives which consider these findings should be designed for the control of schistosomiasis in Eggua.